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The unwelcome visitor.
Singapore Med J. 2012 Aug; 53(8):508-11; quiz 512.SM

Abstract

Gout is a chronic, progressive inflammatory disease with intermittent arthritic flares, which should not be regarded as a minor inconvenience or nuisance. It can be effectively controlled when the patient's serum urate level is reduced to less than 360 μmol/l (6 mg/dL) by consistent use of urate-lowering pharmacotherapy. Colchicine prophylaxis for gouty flares during titration of urate-lowering therapy has been underused. Holistic long-term management of gout must encompass patient education, evidence-based dietary advice, screening and aggressive treatment of comorbidities such as hypertension, diabetes mellitus, dyslipidaemia and renal impairment. Acute therapies for recurrent attacks with non-steroidal anti-inflammatory drugs, colchicine and/or corticosteroids should be used judiciously, especially in the elderly, due to the risk of toxicities. With appreciation of the underlying pathogenesis and artful use of the limited drug options, control of gout can be effectively achieved, bringing tremendous satisfaction to the patient and doctor.

Authors+Show Affiliations

Teng GG
University Medicine Cluster, Division of Rheumatology, National University Health System, Singapore. gim_gee_teng@nuhs.edu.sg
Tong CY
No affiliation info available
How CH
No affiliation info available
Goh LH
No affiliation info available

MeSH

Adrenal Cortex HormonesAdultAnti-Inflammatory Agents, Non-SteroidalChronic DiseaseColchicineGoutHumansMaleUric Acid

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

22941126

Citation

Teng, Gim Gee, et al. "The Unwelcome Visitor." Singapore Medical Journal, vol. 53, no. 8, 2012, pp. 508-11; quiz 512.
Teng GG, Tong CY, How CH, et al. The unwelcome visitor. Singapore Med J. 2012;53(8):508-11; quiz 512.
Teng, G. G., Tong, C. Y., How, C. H., & Goh, L. H. (2012). The unwelcome visitor. Singapore Medical Journal, 53(8), 508-11; quiz 512.
Teng GG, et al. The Unwelcome Visitor. Singapore Med J. 2012;53(8):508-11; quiz 512. PubMed PMID: 22941126.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The unwelcome visitor. AU - Teng,Gim Gee, AU - Tong,Chung Yan, AU - How,Choon How, AU - Goh,Lay Hoon, PY - 2012/9/4/entrez PY - 2012/9/4/pubmed PY - 2013/5/29/medline SP - 508-11; quiz 512 JF - Singapore medical journal JO - Singapore Med J VL - 53 IS - 8 N2 - Gout is a chronic, progressive inflammatory disease with intermittent arthritic flares, which should not be regarded as a minor inconvenience or nuisance. It can be effectively controlled when the patient's serum urate level is reduced to less than 360 μmol/l (6 mg/dL) by consistent use of urate-lowering pharmacotherapy. Colchicine prophylaxis for gouty flares during titration of urate-lowering therapy has been underused. Holistic long-term management of gout must encompass patient education, evidence-based dietary advice, screening and aggressive treatment of comorbidities such as hypertension, diabetes mellitus, dyslipidaemia and renal impairment. Acute therapies for recurrent attacks with non-steroidal anti-inflammatory drugs, colchicine and/or corticosteroids should be used judiciously, especially in the elderly, due to the risk of toxicities. With appreciation of the underlying pathogenesis and artful use of the limited drug options, control of gout can be effectively achieved, bringing tremendous satisfaction to the patient and doctor. SN - 0037-5675 UR - https://www.unboundmedicine.com/medline/citation/22941126/The_unwelcome_visitor_ L2 - https://medlineplus.gov/gout.html DB - PRIME DP - Unbound Medicine ER -